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Mda Salt Intake Eng
Mda Salt Intake Eng
INTAKE SURVEY
IN THE REPUBLIC
OF MOLDOVA, 2016
DIETARY SALT
INTAKE SURVEY
IN THE REPUBLIC
OF MOLDOVA,
2016
AUTHORS
Francesco P Cappuccio Division of Health Sciences, Warwick
Medical School, University of Warwick,
Coventry, United Kingdom; and Head
of the WHO Collaborating Centre for
Nutrition.
Lanfranco D’Elia Department of Medicine, Federico II
University of Naples, Italy; and WHO
Collaborating Centre for Nutrition,
Coventry, United Kingdom.
Galina Obreja State University of Medicine and
Pharmacy “Nicolae Testemitanu”,
Chișinău, Republic of Moldova.
Angela Ciobanu Public Health Officer, WHO Country
Office in the Republic of Moldova,
Chișinău, Republic of Moldova.
KEYWORDS
SALT INTAKE
SODIUM
POTASSIUM
IODINE
DIETARY INTAKE
REPUBLIC OF MOLDOVA
DISCLAIMER
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ABSTRACT
High salt consumption is an important determinant of high blood pres-
sure and reducing it would improve health outcomes by lowering car-
diovascular disease and therefore death rates. Reducing salt intake has
been identified as one of the most effective public health measures and
is one of the leading targets at global, regional and national levels to
reduce the burden of noncommunicable diseases. The purpose of the
Dietary Salt Intake Survey in the Republic of Moldova was to establish
current baseline average consumption of salt (sodium), potassium and
iodine through 24-hour urinary excretion testing among a random
sample of the adult population (aged 18–69 years), and to assess the
knowledge, attitudes, practices and behaviour around dietary salt in
order to enable more efficient planning and the implementation of an
effective salt-reduction strategy in the Republic of Moldova. The survey
was a population-based survey of adults aged 18–69 years and carried
out in three stages: questionnaire survey, physical measurements, and
24-hour urine collections. The sample for the survey was selected us-
ing a stratified probabilistic method in three stages from the master
sample used by the National Bureau of Statistics, to be nationally rep-
resentative. From a total of 1950 individuals selected from the sampling
frame, 1307 (67%) provided suitable data for inclusion and the final
sample included 858 participants.
CONTENTS
List of illustrations........................................................................................................VII
Foreword......................................................................................................................... IX
Acknowledgements......................................................................................................... X
Executive summary......................................................................................................XII
1. Background.............................................................................................................. 1
3. Survey methodology...............................................................................................4
4. Survey results........................................................................................................ 14
4.1 Recruitment and response rate......................................................................14
4.2 Sex and age distribution of respondents...................................................... 15
4.5 Anthropometry................................................................................................17
4.6 Blood pressure and pulse rate....................................................................... 18
4.7 UNa excretion..................................................................................................20
4.8 UK excretion.................................................................................................... 22
4.9 Urinary volume and UCr excretion...............................................................24
4.10 UI excretion.....................................................................................................24
4.11 Proportion of the population meeting WHO target recommendations
for sodium, potassium and iodine consumption.............................................. 25
4.12 Dietary salt: knowledge, attitudes and practices........................................26
4.13 Fruit and vegetable consumption.................................................................28
4.14 Food consumption frequency........................................................................28
4.14.1 Bread......................................................................................................28
4.14.2 Cereals...................................................................................................28
4.14.3 Pizza, pie and pasta..............................................................................29
4.14.4 Salty snacks.......................................................................................... 29
4.14.5 Processed meat products.....................................................................29
4.14.6 Processed fish products.......................................................................29
4.14.7 Dairy products......................................................................................29
4.14.8 Pickled and marinated vegetables, sauces........................................30
5. Conclusions............................................................................................................ 32
6. References.............................................................................................................. 34
7. Annex 1. Questionnaire.........................................................................................36
It was estimated that the citizens of the Republic of Moldova have a high level of dietary
sodium intake, but data were not available on the actual figures. The objectives of
the National Salt Intake Survey were: to provide baseline data on sodium, potassium
and iodine consumption across a random sample of the adult population; to identify
food products that contribute to the population’s high dietary sodium intake (along
with their frequency of consumption); to evaluate the iodine content in the samples
of table salt used in the population’s diet; as well as to assess their knowledge,
attitude, practices and behaviour around dietary salt. Intake of sodium, potassium
and iodine were estimated by measuring urinary excretion, which closely reflects
an individual’s intake.
The findings of the study will be used to design effective national population-
based interventions directed at reducing dietary sodium intake through a whole-
of-government and whole-of-society approach and at better handling high blood
pressure levels and the associated cardiovascular risks among the population.
Special thanks go to the team of the National Public Health Agency (now the
national Public Health Agency), who was involved in preparation of the survey and
data collection.
Financial support
The WHO Regional Office for Europe would like to express its gratitude to the Swiss
Agency for Development and Cooperation for financial support in conducting the
survey and preparing this report as part of the project “Support to strengthening
governance and policy dialogue in health sector – 2nd phase”.
Contributors
Writing group: Francesco P Cappuccio, Division of Health Sciences, Warwick Medical
School, University of Warwick (United Kingdom) and Head of the WHO Collaborating
Centre for Nutrition; Lanfranco D’Elia, Department of Medicine, Federico II University
of Naples (Italy) and WHO Collaborating Centre for Nutrition; Galina Obreja, State
University of Medicine and Pharmacy “Nicolae Testemitanu”, Chișinău (Republic
of Moldova); and Angela Ciobanu, Public Health Officer, WHO Country Office of the
Republic of Moldova, Chișinău (Republic of Moldova).
Consultancy support in data collection, cleaning and preparation for analysis: Stefan
Savin, Technical Officer, Surveillance and Population-based Prevention, Prevention
of Noncommunicable Diseases, WHO, Geneva (Switzerland).
From the National Bureau of Statistics: Lilian Galer and Calincu Dmitrii.
From the National Centre of Public Health (now the National Public Health Agency):
Valentina Bors, Tatiana Eremciuc, Ala Gheorghiev, Mariana Gincu, Vasile Odobescu,
Vitalie Puris, Ion Salaru, Raisa Scurtu, Natalia Silitrari, Alexandra Silnic and Nelea
Tabuncic.
From regional centres of public health: Vasile Moraru, Elena Revenco (Balti
municipality); Lilia Gurin (Basarabeasca District); Veaceslav Carp, Stanislav
Ovcinicov, Igor Berbec (Cahul District); Iurie Bobu (Falesti District); Nicolae David
(Hancesti District).
Background
In the Republic of Moldova, noncommunicable diseases are the leading cause of
death, and CVD represents the main cause of population morbidity and mortality,
accounting for every second death in 2016. High blood pressure (hypertension) and
unhealthy diet are the leading risk factors for most of the CVD burden in the Republic
of Moldova.
Objective
The overall objective of the present survey was to establish the current baseline
average consumption of salt (sodium), potassium and iodine in a random sample of
men and women in the Republic of Moldova.
Methods
The survey was carried out in three stages: questionnaire survey, physical
measurements, and 24-hour urine collections. The sample for the survey was selected
using a stratified probabilistic method in three stages from the master sample used
by the National Bureau of Statistics (NBS), to be nationally representative. From 1950
households and individuals selected from the sampling frame, 1307 (67%) provided
suitable data for inclusion. Of these, 449 (34%) were excluded during quality-
control checks (on completeness of urine collections). The final sample included 858
participants (66% of the suitable sample), of which 326 were men and 532 women,
aged between 18 and 69 years.
1. BACKGROUND
T
he Republic of Moldova is a lower-middle-income country with a population of
3.4 million, of which 53% live in rural areas. It is situated in south-eastern Europe
and has common borders with Romania and Ukraine. The administrative
structure consists of municipalities, an autonomous territorial-administrative unit,
and districts divided into communes. The country’s gross domestic product per capita
is increasing, but remains lower than that of other countries in the region.
The country has been undergoing an epidemiological transition since the 1990s.
As a result, the prevalence of disease related to lifestyle and health behaviours
– including CVD, diabetes, cancer, chronic hepatitis and cirrhosis – is increasing
steadily and these diseases have become the leading causes of population mortality.
Noncommunicable diseases (NCDs) are the leading cause of death in the Republic
of Moldova; responsible for more than 85% of all deaths annually. As is the case in
other developing countries, the Republic of Moldova is now facing a double burden of
disease, comprising newer challenges, such as obesity and NCDs, as well as infectious
diseases, such as tuberculosis and HIV/AIDS. According to national health statistics
from 2016, the following diseases were the leading causes of death in the Republic
of Moldova (1): diseases of the circulatory system (617.3 per 100 000 population);
neoplasms (175.3 per 100 000 population); chronic hepatitis and cirrhosis (80.1 per
100 000 population); injury and poisoning (66.2 per 100 000 population); and diabetes
(11.5 per 100 000 population). Diseases of the circulatory system are the leading cause
of population morbidity and mortality, and accounted for every second death in 2016
(1).
High blood pressure and unhealthy diet are the leading risk factors for CVD in the
world and among the risk factors that account for most of the disease burden in the
Republic of Moldova (2). High salt consumption is an important determinant of high
blood pressure and reducing it can directly improve health outcomes and indirectly
reduce overall mortality through the beneficial effects on systolic blood pressure
(SBP) and diastolic blood pressure (DBP). In the Republic of Moldova, the prevalence
of raised blood pressure in adults aged 18 years and over was 40% in 2013, with no
difference between the sexes. It is a common habit in the Republic of Moldova to
Dietary Salt Intake Survey in the Republic of Moldova, 2016 1
add salt to food at the table and when cooking, as well as to eat processed foods
that have high salt content (2). The STEPS survey of noncommunicable disease risk
factors (carried out in 2013–2014) indicated that 24.3% of respondents always or often
added salt before eating or while eating, and 32.4% of respondents always or often
ate processed foods that are high in salt (2).
WHO currently recommends that adults should consume no more than 5 g of salt
per day (8). Even though sodium intake varies in populations across the world, in
the vast majority of countries, salt intake is high and it exceeds both physiological
requirements and recommendations (9,10). The Republic of Moldova lacks data on
actual salt consumption. The European Food and Nutrition Action Plan 2015–2020
recommends that countries adopt comprehensive salt-reduction strategies (11). Salt-
reduction strategies in the WHO European Region, including the Republic of Moldova,
encompass monitoring and evaluation actions as one of their important pillars
(12,13). Hence, comprehensive, current data on salt intake in Moldova are urgently
needed, using at least one accurately collected 24-hour urine sample for assessing
UNa, which is regarded as the gold standard method to assess salt consumption, at
least for a population average (14).
Iodine deficiency is a public health problem in the Republic of Moldova and salt
iodization has been implemented since the late 1990s to prevent iodine deficiency
disorders. Other voluntarily iodized foodstuffs, including bottled iodized water,
are available on the internal market, which may increase iodine intake in some
population groups. A WHO special expert consultation held in 2013 concluded that
policies are needed to (a) increase salt iodization and (b) reduce salt intake to less
than 5 g/day. Such policies are also compatible with each other.
The National Salt Intake Survey is a part of the activities foreseen under the Biennial
Collaborative Agreement between the WHO Regional Office for Europe and the
Ministry of Health, Labour and Social Protection of the Republic of Moldova within
the project “Support to strengthening governance and policy dialogue in the health
sector, 2nd phase”, funded jointly by WHO and the Swiss Agency for Development and
Cooperation. It is also reflected in national policy documents, such as the National
Programme on Food and Nutrition for 2014–2020 and the National Action Plan for
2016–2020 on the implementation of the National Strategy for Prevention and Control
of Noncommunicable Diseases 2012–2020, as a monitoring tool to measure progress
in implementing national policies on NCDs.
3. SURVEY
METHODOLOGY
3.1 Survey design
The survey was carried out using three consecutive steps, similar to the WHO
concept of using a stepwise approach for the surveillance of risk factors for NCDs,
and considering local needs and resources.
STEP 3 comprised 24-hour urine sample testing for sodium, potassium, iodine and
creatinine content, as well as household salt testing for iodine.
The adapted version of the instrument was translated into Romanian and Russian,
and used to take into consideration specific characteristics/requirements within the
country.
A total of 1307 randomly selected respondents participated in the survey. They were
all aged 18–69 years, and the group comprised both sexes, as well as residents of all
districts and the territorial-administrative unit of Gagauz-Yeri, along with Chișinău
and Balti municipalities. The survey did not cover the districts from the left bank of
the Nistru River and the municipality of Bender.
In general, to detect approximately 1 g reduction in salt intake over time using 24-hour
UNa excretion, with a standard deviation of 75 mmol/day (alpha = 0.05, power = 0.80), a
minimum sample of 120 individuals per age and sex stratum is recommended (17,18).
To account for attrition (e.g. non-participation, incomplete collection or implausible
values), which may be as high as 50%, up to 240 people per age and sex stratum
should be invited to participate. Thus, a minimum recommended sample size of 120
was multiplied by 8 estimated age and sex groups and adjusted for an anticipated
non-response rate of 50%. Calculations resulted in a minimum final sample size of
1920 individuals (see Formula 1).
The survey sample ensures accuracy of the results both at national and area of
residence (urban/rural) levels, as well as by sex and by age group (18–29, 30–44, 45–59
and 60–69 years).
The estimated sample size consisted of 50 primary sampling units (PSUs; communes
or cities, or sectors within cities), 1920 secondary sampling units (SSUs; households),
and 1920 tertiary sampling units (TSUs; individuals) (Table 3.1).
3.4 Sampling
A probabilistic master sample (used by the National Bureau of Statistics (NBS) for the
Household Budget Survey) was applied in order to select the sample for this survey.
The nationally representative stratified probabilistic sample was extracted in three
stages (phases). The list of all PSUs (communes, cities/sectors in the cities) was used
as a sampling base at Phase 1, the list of all households at Phase 2 and the list of all
eligible individuals within the selected households at Phase 3 (Table 3.2).
In the first stage, two phases of sampling were applied. The Phase 1 survey base
consisted of 931 PSU, of which 150 PSU were selected, with the probability proportional
The 150 PSU extracted at Phase 1 represented the survey base of the second sampling
phase (Phase 2). These 150 PSU were stratified by area of residence, resulting in two
strata – urban and rural. Within each stratum, the PSUs were ordered from north
to south to obtain a default geographical stratification. Then, from each stratum,
the required number of PSU (20 urban PSU and 30 rural PSU) were extracted, with a
probability of extraction proportional to their size (number of population) using the
systematic extraction procedure.
For Phase 2 of sampling, the list of respondent households within the Household
Budget Survey carried out by the NBS of the Republic of Moldova in 2014 was used as a
sampling base. Thus, 39 households within each PSU were randomly selected, using
the systematic extraction procedure.
Phase 3 selection took place on site, within the 1950 households selected at the
previous stage. This stage involved the random selection of only one individual (aged
18–69 years) from within the household to respond to the questionnaire.
PSU sample selection at Phase 1 and SSU selection (of households) at Phase 2 of
sampling were carried out in collaboration with the NBS. Respondent selection at
Phase 3 of sampling took place in the field, and was carried out by the interviewers
(random selection using an Android app).
The survey was carried out in accordance with the Declaration of Helsinki (20,21) and
the principles of good clinical practice. Ethical approval for the survey was obtained
from the Committee of Research Ethics of the National Public Health Agency. All
participants were informed about the survey goal and objectives, as well as the
procedures that would be applied. Prior to data collection the selected household
participant received information and signed a consent form. To ensure confidentiality
of all collected and archived data, unique identification numbers were assigned to
each participant and data registers refer only to these numbers. The information
and consent forms were available in both Romanian and Russian languages.
Field data collectors and field data supervisors were recruited from the National
Centre of Public Health (now the National Public Health Agency) and the territorial
centres of public health from among the individuals who had previously participated
The training of data collectors was conducted by the survey’s technical working group,
which previously performed similar functions in the STEPS 2013 survey. The training
session on 5 December 2015 was performed in cooperation with WHO expert, Professor
Francesco Cappuccio from the WHO Collaborating Centre for Nutrition of the University
of Warwick (United Kingdom). It focused in particular on the methodology of how
to collect complete and reliable 24-hour urine samples. During the second workshop,
survey staff was trained on the methodology of communicating with households
selected to participate in the survey, obtaining informed consent from the survey
participants, and delivering the questionnaire. The core of the training focused on
the skills required to use an electronic device (tablet) for the selection of one survey
participant at the household level and for data entry.
The trained data collectors carried out preliminary testing in Chișinău, aiming to
validate the field data collector’s skills in carrying out the various elements involved
in the data collection exercise. The preliminary testing tasks comprised selecting one
individual from within the household, obtaining informed consent, delivering the
questionnaire, carrying out physical measurements, collecting urine and salt samples
and sending them to the laboratories for testing. Four teams, each comprising two
interviewers and one coordinator/supervisor, participated in data collection; each
team delivered the questionnaire, performed physical measurements, and collected
urine and salt samples on three to four individuals.
In the present survey, the WHO STEPS Instrument for Non-Communicable Disease
Risk Factor Surveillance was adapted and used for data collection and physical
measurements. The adapted questionnaire was translated into Romanian and
Russian. All participants were visited at home between 21 July and 5 September 2016 by
field team members, who were specially trained health professionals. Every selected
participant was informed verbally and in writing about the survey. After obtaining
informed consent and applying exclusion criteria (Table 3.3), a questionnaire was
carried out with each participant and physical measurements were taken, used to
calculate body mass index (BMI) and waist-to-hip ratio (WHR). Upon completion of
the measurements, the survey participant was informed about the urine collection
procedure; the necessary equipment, the registration form and the participant guide
on urine collection were provided.
In order to assess the diet pattern of the surveyed population, the respondents were
asked about frequency of consuming foods that contribute significantly to salt
intake; frequency of fruit and vegetable consumption; mean number of portions of
these foods consumed daily; type of oils and fats used for meal preparation; and
knowledge, attitudes and practices on dietary salt. Consumption of foods which
contribute significantly to salt intake and of fruit and vegetables was assessed in
terms of number of servings, with a serving being equal to 80 g. Showcards were
used to collect data on consumption of these foods within a certain time frame (day,
week, and month). Oil and fat intake was assessed by asking about the type of oil or
fat most frequently used for cooking.
Dietary salt consumption was evaluated by asking about frequency of adding salt
or salty sauce to food during preparation/cooking, or before or while eating; and/
or frequency of consuming high-salt processed foods. Participants were asked also
about their perception of the quantity of salt they consumed and its link with health
problems; the importance of reducing salt intake; as well as measures undertaken
to control it.
History of diabetes, CVD and raised blood pressure was determined by asking whether
specific measurements for these purposes had been performed by a doctor or health
care worker. Participants were also asked about any medication taken.
Participants were asked about any advice given by a doctor or a health worker during
the past three years relating to reducing common risk factors for NCDs.
Participants were not allowed to smoke, exercise, overeat, consume caffeine or have
a full bladder for 30 minutes before the measurements were taken. Body weight,
height, waist circumference, hip circumference, SBP, DBP, and heart rate were
measured in all participants. Body weight (in kilograms) and height (in centimetres)
were measured with an electronic growth management scale. This is a combined
device (scale for body weight with height gauge) with a laser, suitable for survey
purposes. It measures body weight and height, and calculates BMI; a ratio of body
weight in kilograms to the square of body height in metres, calculated according to
Formula 2.
Laboratory tests were performed for sodium, potassium, creatinine and iodine in
24-hour urine samples, and for iodine in the sample of table salt collected from
within the participant’s home.
Sodium and potassium content in the urine samples were determined using an ion-
selective electrode with a Beckman Coulter Synchron CX5PRO System, expressed in
mmol/L (24). Creatinine content in participants’ urine was measured using a kinetic
modification of the Jaffe method, expressed in mg/L (25). UI was determined using
the ammonium persulfate digestion method with spectrophotometric detection
by Sandell-Kolthoff reaction, expressed as mcg/L (26). Iodine determinations in
table salt were made by titration method (27). Sodium, potassium and creatinine
determinations were carried out in a private accredited laboratory (ICS Medical
Laboratory Synevo SRL), and iodine determinations in urine and table salt were
performed at the National Public Health Agency.
Data collection for the survey was carried out by four teams of four people; each
team consisted of a coordinator/supervisor, two interviewers, and a driver. Local
guidance, in the form of a family doctor or a nurse, was brought in to reach selected
households. On the day of data collection, the selected households were visited, and
general information was given (verbally) on the goal and objectives of the survey.
Then one participant was selected from among all adults aged 18–69 years in each
household. Further information was given to the selected participant and active
consent was requested. Survey data collection and urine collection, including
physical measurements, then took place at the participant’s home.
At the end of the first visit each participant was given a leaflet with explanations,
along with the necessary equipment (a 5-litre screw-cap container for urine
collection and storage; a 2-litre screw-cap container for temporal collection of urine
made away from home; a 1.5-litre cup with funnel, for women, to be used during
The participants were carefully instructed on the urine collection methodology. The
so-called first-pass urine of the starting day was discarded and the time was noted.
All urine passed thereafter was collected in the container provided. Participants were
instructed to keep urine in a dark and cool place.
Upon completion of the urine collection, the next day, field team members
measured/weighed the total volume of urine collected. They thoroughly mixed the
urine container, collecting two urine aliquots in two separate tubes, which were
taken to a laboratory for testing. The rest of the urine was discarded. At the same
time, a sample (50–70 g) of household table salt (used for cooking and as table salt)
was collected. The urine samples were stored in a cool place for a maximum of
24 hours until transportation to the laboratory was possible. Sodium, potassium,
and creatinine determinations were carried out immediately, and urine samples
for iodine determinations were frozen at -40oC and tested at a later date (within a
month).
In addition, samples of the most frequently sold foods were collected randomly from
a predefined list of food categories (determined within the FEEDcities project (23)
and were tested for salt content using the titrimetric method at the laboratory of the
National Centre of Public Health (now the National Public Health Agency).
The data collection monitoring team comprised four representatives from the
National Centre of Public Health (now the National Public Health Agency). Monitoring
was carried out in the field, providing technical and logistical support to the data
collection teams through the data collection process.
Collection of all the survey data was carried out using electronic devices (Android
5.0 tablets). Data from nine electronic devices (eight with field data collected and one
with laboratory results) were uploaded to the Open Data Kit (ODK) Collect database,
completing the data entry process. Each survey respondent had a four-digit unique
identifier (quick response (QR) code).
Data cleaning and weighting was performed at the end of the field work, when all
information collected using electronic devices had been uploaded to the central server.
The purpose of the data cleaning procedure was to identify and correct all possible
errors that may have occurred during data collection and to prepare the dataset
for analysis, thus minimizing the impact of any errors on the study results. The
process started with the download of three data files from the central server; each of
them representing data collected during the three days of the survey. The first step
consisted of identifying duplicates. In order to be able to combine those three pieces
of information later, a unique QR code was used for every respondent. During data
collection the QR code was scanned and stored in the memory of the Android device
and later exported to the server. In some cases, the code was entered manually. This
was allowed in instances when the QR code had been damaged and was unreadable.
When inspecting the data files, it was found that in many cases the code had been
entered manually, and some of these were duplications. It was possible to correct the
duplicate entries by comparing other records on age, sex, location and other variables
among all three files. After the duplications had been cleaned, data files from the
three data collection days were merged (using the QR codes as unique identifiers).
The next step was to identify incomplete records by analysing the initial combined
dataset. In total, 20 records were dropped from the dataset because key variable
records were missing.
The screening of the dataset was performed next in order to identify all possible records
with lack of or excess data, outliers, strange patterns and other inconsistencies.
Owing to the fact that the survey used electronic data collection based on ODK
software which allows the limitation of data entry within pre-established ranges, as
well as use of skip logic questions and links – the number of outliers and data format
errors was considerably reduced. In some cases, inconsistencies were identified and
some of these, where possible, were corrected. The final dataset, with 184 variables,
was then considered clean and ready for the next phase.
Weighting of the dataset was performed in order to make the survey results
representative of the target population in the country; namely, adults aged 18–69 years.
Data weighting was conducted using the sample weight and population distribution
weight. The non-response rate was not applied in the current survey because the
age, sex and other characteristics of non-respondents were not known. Sample
weight was computed using the sample design information provided in the survey
documentation. The final sample weight was calculated as the inverse probability of
selection, at every stage of selection up to the individual level, within the household.
The selection technique was considered when computing the probability of selection
at each stage. The first and second selection steps (PSUs and SSUs) where performed
using the PPS procedure and the probability of selection was calculated accordingly.
The next selection step was to choose households within the SSUs, using a random
selection procedure. The final step was to select one eligible household member using
The second phase of data weighting was to calculate the population distribution
weight that allows for the correction of over- or under-representation in the sample
of the targeted age/sex groups. For that reason, both the target population (aged 18–69
years) and the weighted counts of the survey population were divided into eight age
and sex groups and the proportion of each group was calculated. The population
distribution weight specific to each age/sex group was calculated by dividing the
proportion of a specific group from the target population by the proportion of the
same group in the survey population.
Finally, the sample weight of each respondent was multiplied by the population
distribution weight for the specific age/sex group in order to get the final survey
weight.
The population was also stratified in groups by sex (men and women), by age (18–29,
30–44, 45–59, and 60–69 years), and by residence status (urban and rural settings).
Moreover, in order to convert urinary output to dietary intake, the UNa excretion
or UK values (mmol/day) were first converted to mg/day. Then, sodium values were
multiplied by 1.05, while potassium values were multiplied by 1.3 (28). The conversion
from dietary sodium (Na) intake to salt (NaCl) intake was made by multiplying the
sodium value by 2.542 (as shown in Formula 3).
A T-test for unpaired samples or analysis of variance (ANOVA) was used to assess
differences between group means. A Pearson chi-square test was used to test the
association between categorical variables. The results were reported, as appropriate,
as mean (standard deviation (SD) and/or 95% confidence interval (CI)), median, or as
percentages. Two-sided P-values below 5% were considered statistically significant.
Statistical analyses were performed with IBM software package SPSS Statistics
version 20.
From the 1950 households and individuals originally selected from the sampling
frame, 1307 provided suitable data for inclusion in the survey database [1307/1950 =
67%]. Of these, 449 (34%) were excluded during quality control, as indicated in Fig.
4.1, following a stepwise procedure based on assessing the completeness of the 24-
hour urine collection: those who had missing data (n=11); all those who had declared
missing more than one void of urine collection (n=263); those with urinary volume
of less than 500 mL (n=0); those with a collection duration of less than 23 hours or
more than 25 hours (n=77); those without urinary creatinine (UCr) (n=2); and the
participants whose UCr collection was outside of 2 SDs of the sex-specific distribution
of UCr (n=37, men=13, women=24) [UCr for men > 28.442 – for women < 0.925 & >
21.745]. According to the selection criteria, the final sample was 858 (326 men and 532
women) (Fig. 4.1). The geographical sampling is provided in detail in Fig. 4.2.
Fig. 4.1. Stepwise procedure for excluding records after assessing the completeness
of 24-hour urine collections
1 296
[M=493, F=803]
Participants that have declared missing more than 1 void (n=263)
There were 326 men and 532 women (Table 4.1). The age groups were equally
represented by sex. Younger participants (aged 18–29 years) were under-represented
compared to other age groups.
A total of 3.5% of all respondents reported having had a heart attack or chest pain
from heart disease or stroke (see Annex 2, section 8.6 CVD history, Table A130). A
total of 12.4% of respondents reported taking aspirin regularly and 3.5% of them took
statins to prevent or treat CVD (Table A131 and Table A132). The proportion of women
who reported taking aspirin and statins was higher than that of men (Table A132).
Information on healthy lifestyle advice for reducing the risk for CVD provided by a
doctor or health worker is reported in Annex 2 (section 8.7 Lifestyle advice, Tables
A133 to A138).
A total of 5.8% of respondents had never had their blood pressure measured (see Annex
2, section 8.5 Personal medical history, Table A111). A total of 73.9% had undergone
blood pressure measurement but had not been diagnosed with hypertension; 7.1%
had been diagnosed with high blood pressure more than a year before survey and
13.2% had been diagnosed with high blood pressure within the last 12 months, prior
to data collection. The proportion of women diagnosed with high blood pressure both
more than a year before the survey and within the past 12 months was higher than
that of men (Tables A109 to A111).
Compliance with high blood pressure treatment regimens was low. About half of all
respondents diagnosed with hypertension were taking medication prescribed by a doctor
or health worker; this level of compliance increased with age (Table A112). Information on
healthy lifestyle advice for raised blood pressure provided by a doctor or health worker is
reported in Annex 2 (section 8.5 Personal medical history, Tables A113 to A116). About one
fifth of respondents reported having seen a traditional healer or having taken herbal or
traditional remedies for high blood pressure (Table A117 and Table A118).
A total of 16.5% of all respondents had never had their blood sugar measured and
80.0% of them had undergone the blood sugar test but had not been diagnosed with
diabetes. A total of 1.2% of all respondents had been diagnosed with high blood sugar
more than 12 months before the survey and 2.4% within the previous 12 months
(see Annex 2, section 8.5 Personal medical history, Table A121). The percentage of
respondents who had never undergone a test for high blood sugar was higher among
younger age groups compared to older age groups. The proportion of respondents
diagnosed both within the past 12 months and previously was also associated with
age (being higher in older age groups).
The percentage of respondents who never had their blood sugar measured was
higher among women than men (Tables A119 and A120). The proportion of men who
had undergone blood sugar measurement but had not been diagnosed with diabetes
was higher than that of women.
4.5 Anthropometry
The baseline characteristics of the participants’ height, weight and BMI are reported by
sex, age group and area of residence. Men were found to be taller than women (Table
4.2) across all age groups. They were also heavier, with the exception of the age group
60–69 years (Table 4.3). The resulting BMI distribution indicated that women had a
higher BMI than men across all age groups (Table 4.4). The combined percentages of
the mean BMI was higher within rural areas (BMI 29.1; versus BMI 26.6 in urban areas),
with highest mean BMI recorded among women from rural areas (mean BMI 29.6 kg/
m2) (see Annex 2, section 8.2 Anthropometry and physical measurements, Table A18).
Obesity rates (BMI ≥30) were found to be higher in women than in men (35.3% versus
26.3%), with the highest rate among older adults aged 45 years and above (Table A19
and Table A20). In contrast, prevalence of overweight (BMI 25.0–29.9) was higher in
men than in women (39.3% versus 37.6%). Further classifications by area of residence
and prevalence of overweight or obesity by sex and age can be seen in the Annex 2
(section 8.2, Tables A18 to A23). Table 4.5, Table 4.6 and Table 4.7 show the sex and age
distributions of waist and hip circumferences and the WHR; a measure of adiposity.
Younger men (aged under 59 years) had a higher WHR than women (Table 4.7).
Table 4.2. Mean height (cm) of participants, by sex and age group
Age Men Women
(years) n Mean 95% CI n Mean 95% CI
height height
(cm) (cm)
18–29 44 173.7 170.9 176.5 63 165.2 163.1 167.3
30–44 92 175.6 174.0 177.2 130 163.2 162.0 164.4
45–59 115 171.7 170.3 173.1 180 163.5 162.5 164.5
60–69 72 170.6 168.7 172.4 151 160.9 159.9 161.9
18–69 323 172.8 171.9 173.7 524 162.9 162.3 163.5
Table 4.3. Mean weight (kg) of participants, by sex and age group
Age Men Women
(years) n Mean 95% CI n Mean 95% CI
weight weight
(kg) (kg)
18–29 44 71.4 68.1 74.7 63 65.7 62.2 69.3
30–44 92 82.6 79.8 85.4 130 71.8 69.1 74.4
45–59 115 84.3 81.3 87.4 180 80.8 78.7 83.0
60–69 73 94.9 72.5 117.2 151 77.6 75.3 79.9
18–69 324 84.5 79.3 89.6 524 75.8 74.5 77.2
Table 4.5. Mean waist circumference (cm) of participants, by sex and age group
Age Men Women
(years) n Mean 95% CI n Mean 95% CI
circumference circumference
(cm) (cm)
18–29 42 80.1 77.0 83.1 63 78.4 75.1 81.7
30–44 92 92.9 90.1 95.6 130 85.3 82.7 87.8
45–59 113 97.5 94.8 100.2 179 96.5 94.6 98.4
60–69 71 97.2 93.3 101.1 148 97.7 95.6 99.8
18–69 318 93.8 92.1 95.5 520 91.8 90.5 93.1
Table 4.6. Mean hip circumference (cm) of participants, by sex and age group
Age Men Women
(years) n Mean 95% CI n Mean 95% CI
circumference circumference
(cm) (cm)
18–29 42 94.5 89.6 99.4 63 97.4 94.5 100.2
30–44 92 100.2 97.8 102.5 130 102.2 100.1 104.4
45–59 113 101.6 99.5 103.6 179 110.5 108.5 112.5
60–69 71 102.8 100.0 105.6 148 109.4 107.3 111.4
18–69 318 100.5 99.2 101.9 520 106.5 105.3 107.7
Both SBP and DBP increased with age in both sexes (Table 4.8 and Table 4.9). Men had
higher SBP and DBP than women across all age groups. Of all the study respondents,
excluding those taking medication for raised blood pressure, 38.2% had hypertension
(SBP ≥140 mmHg and/or DBP ≥90 mmHg) with higher proportion of men (41.1%) than
of women (36.4%) (see Annex 2, section 8.2, Table A24). The proportion of respondents
Table 4.8. Mean SBP (mmHg) of participants, by sex and age group
Age Men Women Both sexes
(years) Mean Mean Mean
n 95% CI n 95% CI n 95% CI
SBP SBP SBP
18–29 44 124.1 121.1 127.2 63 116.3 112.9 119.7 107 119.5 117.1 122.0
30–44 92 130.2 127.6 132.7 130 121.8 119.1 124.6 222 125.3 123.3 127.3
45–59 115 138.8 135.7 142.0 180 136.7 133.4 140.0 295 137.5 135.2 139.9
60–69 72 146.8 141.2 152.5 151 145.5 141.9 149.1 223 145.9 142.9 148.9
18–69 323 136.1 134.1 138.2 524 133.1 131.1 135.0 847 134.3 132.8 135.7
Table 4.9. Mean DBP (mmHg) of participants, by sex and age group
Age Men Women Both sexes
(years) n Mean 95% CI n Mean 95% CI n Mean 95% CI
SBP SBP SBP
18–29 44 81.2 79.0 83.3 63 77.8 75.3 80.3 107 79.2 77.5 80.9
30–44 92 85.3 83.4 87.3 130 83.8 82.0 85.6 222 84.5 83.1 85.8
45–59 115 89.0 87.0 90.9 180 88.3 86.5 90.2 295 88.6 87.2 89.9
60–69 72 90.2 87.1 93.3 151 90.7 88.7 92.8 223 90.6 88.8 92.3
18–69 323 87.1 86.0 88.33 524 86.6 85.6 87.7 847 86.8 86.0 87.6
A total of 21.3% of respondents were taking medications but had raised blood pressure
(SBP ≥140 mmHg and DBP ≥90 mmHg), with much higher prevalence among women
than in men (24.9% among women versus 15.5% among men). Almost two thirds
of respondents (74.3%) were not taking medications and had raised blood pressure
(SBP ≥140 mmHg and DBP ≥90 mmHg) with higher prevalence in men (82.4% in men
in comparison with 69.2% in women). The distribution of respondents according to
their level of treatment by sex, age groups and area of residence are reported in
detail in the data tables in the Annex 2 (section 8.2, Tables A28 to A33).
Mean pulse rate was comparable in men and women and did not vary significantly
by age group (Table 4.10).
Mean, median, standard deviation and 95% CI for UNa excretion (in mmol/24h) are
reported in Table 4.11 to Table 4.16 by sex, area of residence and age group. Mean UNa
excretion was 172.7 (SD 79.3) mmol/24h (Table 4.11), equivalent to a mean consumption
of 10.8 g of salt per day (Table 4.12). The graphic distribution of mean UNa excretion
was bell-shaped with a tail towards higher values (Fig. 4.3).
Table 4.12. Daily salt intake (g) overall, by sex and by area of residence
n Mean Median SD 95% CI
Men excreted more sodium than women (mean difference 18.1 mmol/24h, p<0.01).
Excretion was higher in rural than urban areas with a difference in means of
20.3 mmol/24h, p<0.001 (Table 4.13). There was a significant difference between
women in rural areas versus those in urban areas, with a difference in means of
24 mmol/24h, p<0.001 (Table 4.14). Excretion also increased with increasing age (Table
4.15), but more clearly in men (Table 4.16).
100
N=858
Mean=172.7 mmol/24h
80 SD=79.3 mmol/24h
Frequency (n)
60
40
20
0
0 100 200 300 400 500 600
Urinary Na excretion (mmol/24h)
4.8 UK excretion
Mean, median, standard deviation and 95% CI for UK excretion (in mmol/24h) are
reported in Table 4.17 to Table 4.22 by sex, area of residence, and age group. The
distribution of mean UK excretion was bell-shaped with a tail towards higher values
(Fig. 4.4).
Table 4.18. Daily potassium intake (g) overall, by sex and by area of residence
Mean UK excretion was 72.7 (SD 31.5) mmol/24h (Table 4.17), equivalent to 3.7 g of
potassium per day (Table 4.18). Men excreted more potassium than women (mean
difference 5.3 mmol/24h, p=0.02). Excretion was comparable between rural and
urban areas (Table 4.19), and across sexes (Table 4.20). Excretion tended to increase
with increasing age (Table 4.21), but more clearly in men (Table 4.22).
100
N=858
Mean=72.7 mmol/24h
80 SD=31.5 mmol/24h
Frequency (n)
60
40
20
0
0 50 100 150 200
Urinary K excretion (mmol/24h)
Mean urinary volume and UCr excretion are reported in Table 4.23 for the whole sample,
including both men and women and urban and rural settings. As expected, men
excreted more urine than women (probably reflecting higher drinking volumes) and
more creatinine (expression of greater lean body mass) than women. There was less
volume excretion and higher creatinine excretion in rural compared to urban areas.
Table 4.23. Urinary volume (ml/24h) and UCr excretions (mg/24h) overall, by sex
and by area of residence
Creatinine
Volume (ml/24h)
(mg/24h)
n Mean SD Mean SD
Both sexes 858 1441 529 11.7 5.0
4.10 UI excretion
Mean, median, standard deviation and 95% CI for UI excretion (in mcg/24h) are
reported in Table 4.24 by sex and area of residence. The distribution of mean UI
excretion was bell-shaped with a tail towards higher values (Fig. 4.5). Mean UI
excretion was 225 (SD 152) mcg/24h, with a median excretion of 196 mcg/24h (Table
4.24).
Table 4.24. UI excretion (mcg/24h) and iodine content of table salt (mg/kg) overall, by
sex and by area of residence
n Mean Median SD 95% CI
UI excretion (mcg/24h)
Both sexes 856 225 196 152 215–235
Men 326 232 200 154 215–249
Women 530 221 190 150 208–233
Rural 529 225 186 145 211–239
Urban 327 224 202 128 210–238
Iodine content of table salt (mg/kg)
Both sexes 856 21.0 – 18.6 19.8–22.3
Men 326 22.1 – 18.2 20.2–24.1
Women 530 20.3 – 18.9 18.7–21.9
Rural 529 16.7 – 18.6 15.1–18.2
Urban 327 28.1† – 16.5 26.3–29.9
Notes. Urine: p=0.3 (men versus women); p=0.9 (rural versus urban). Salt: p=0.16 (men versus women);
†p<0.001 (rural versus urban).
120
N=856
Mean=224.9 mmol/24h
100 SD=151.8 mmol/24h
80
Frequency (n)
60
40
20
0
0 200 400 600 800 1000 1200
Table 4.25. Proportion of participants meeting WHO recommended targets for salt
and potassium consumption, overall, by sex and by area of residence
Consumption of salt was assessed by asking survey participants about the frequency,
quantity and type of salt used in their household, as well as their cooking habits and
their attitudes towards dietary salt. A total of 35.4% of respondents mentioned that
they added salt always or often before eating or while eating (see Annex 2, section
8.4 Dietary salt, Table A83 and Table A84). The middle age group (30-44 years) showed
26 Dietary Salt Intake Survey in the Republic of Moldova, 2016
the highest proportion of those who added salt always or often before eating or while
eating (39.2%). The percentage of men who added salt always or often to their meal
was significant higher than that of women (Table A83).
A total of 61.3% of respondents reported that they always or often added salt when
cooking or preparing food at home (Table A85 and Table A86); this was the case more
often in rural than in urban areas (Table A86). More than half of the respondents
(64.4%) mentioned that they used iodized salt when cooking or preparing food at
home (Table A87 and Table A88). Consumption of iodized salt, however, tended to
decrease with age (Table A87) and it was higher in urban than in rural areas (Table
A88).
About a quarter (26.7%) of respondents felt they consumed too much salt or far too
much salt, with a higher proportion of men than women believing this (32.1% versus
23.3%) (Tables A91 to A94). More than half acknowledged that consuming too much
salt could cause serious health problems (Tables A95 to A98). Despite the fact that
more than half of respondents were aware that salt consumption can cause serious
health problems, only 28.2% considered lowering salt in diet to be very important
(Tables A99 to A101). More than a quarter of respondents mentioned that they
consumed processed foods high in salt, with more men than women doing so (34.9%
versus 23.5%, respectively) and more people in urban settings than among the rural
population (39.2% versus 20.8%, respectively) (Table A89 and Table A90).
Respondents were asked about actions they take to control salt intake on a regular
basis. A total of 81.7% limited their consumption of processed food high in salt; 22.3%
of respondents were using spices other than salt when cooking and 31.1% mentioned
that they did not add salt when cooking. Only 8.8% of respondents noted that they
looked at salt or sodium content on food labels and 14.3% reported that they bought
low salt/sodium alternatives (Table 4.27) (see section 8.4, Tables A102 to A106). A total
of 33.1% of respondents reported avoiding eating food prepared outside of a home and
0.8% took other measures to control salt intake (Table A107 and Table A108).
Proportion (%)
People who:
(95% C.I.)
81.7
limit their consumption of processed food
[76.9–86.5]
8.8
look at salt/sodium content in foods
[5.3–12.3]
14.3
buy low salt/sodium alternatives
[10.0–18.6]
31.1
do not add salt when cooking
[25.4–36.8]
22.3
use spices instead of salt when cooking
[17.2–27.4]
33.1
avoid eating food prepared outside a home
[27.3–38.9]
0.8
take other measures to control salt intake
[0.3–1.9]
Full results on the consumption of fruit and vegetables are given in Annex 2 (see
section 8.3 Diet, Tables A37 to A50). The average consumption was 4.4 servings per
day. The overall consumption was greater in urban than in rural areas (5.1 versus
4.0 servings per day, respectively). More than half the sample of respondents
(56%) reported consuming fewer than five servings of fruit and vegetables per
day.
Fruit was consumed, on average, 5.2 days a week, while vegetables were consumed
5.8 days a week. Compared to rural areas, urban areas had the most frequent
consumption of fruit (6.0 versus 4.7 days a week) and vegetables (6.4 versus
5.5 days a week). Average servings were 2.19 servings per day of fruit and 2.20
servings per day of vegetables, with more consumed in urban than in rural areas
(2.6 versus 1.9 servings/day of fruit and 2.4 versus 2.1 servings/day of vegetables,
respectively).
Frequency of consumption of food contributing to salt intake during the previous year
was assessed by age group, sex and area of residence by means of a questionnaire
(presented in Annex 1). Respondents were asked about frequency and quantity of
food consumption.
4.14.1 Bread
Bread is one of the staple foods for the population of the Republic of Moldova and
the main source of salt in the diet, alongside salt added to food during cooking or
while eating. Information on bread consumption can be found in Annex 2 (section
8.3 Diet, Tables A51 to A54). The most common form of bread consumed was white
bread. The majority of respondents of both sexes (55.4%) reported consuming white
bread 2–3 times per day. Rural populations consumed higher proportions than urban
populations. One fifth (20.4%) consumed black bread 2–3 times per day. Whole-grain
bread is rarely consumed by the population of the Republic of Moldova; only 1.3% of
respondents reported consuming this type of bread 2–3 times per day.
4.14.2 Cereals
Information on consumption of pizza, pies and pasta are reported in Annex 2 (Tables
A59 to A62). Pizza is not popular among the population of the Republic of Moldova, with
98.5% of respondents consuming this product only once per week or less frequently.
Younger age groups, men, and urban populations were the main consumers of pizza.
Pie, a traditional food in the country, was reported to be consumed 2–4 days per week
by 20.1% of respondents of both sexes, with a higher proportion among men than
women. The proportion of respondents consuming pie 2–4 days per week was higher
among younger age groups and among the urban population. About one in three
respondents (28.1%) reported consuming pasta or macaroni 2–4 days per week, with
a higher proportion among men and among the rural population.
Bread is the biggest contributor to salt intake; every 100 g supplies 1.85 g of salt
(95% CI: 1.62–2.08) to the population’s diet. Taking into account that the average
consumption of bread in the Republic of Moldova is 300 g per day (31),1 it is possible
to assess that bread provides more than the daily recommended amount of salt for
an adult diet (5.55 g as compared to the 5 g recommended by WHO). Sausages and
cheese each supply on average 1.88 g of salt per 100 g of product. Sweet pastry and
ice cream also contribute to the salt intake of the population. Salt content in various
food samples is presented in Table 4.28.
Table 4.28. Salt content in various food samples (grams of salt per 100 g of food)
Food group n Mean 95% CI
(g/100g)
Bread (white and brown) 15 1.85 1.62–2.08
Sausages (salami (boiled), liverwurst*) 65 1.88 1.81–1.95
Cheese (hard) 10 1.88 1.84–1.92
Savoury pastry (pizza, pie) 26 1.28 1.14–1.42
Sweet pastry 41 0.49 0.39–0.59
Salty snacks 18 2.63 1.95–3.31
Canned and semi-prepared meat products 20 1.37 1.18–1.56
Ready-to-eat foods** 8 1.23 1.04–1.42
Smoked fish 4 3.25 2.75–3.75
Butter 3 0.1 0.084–0.12
Ice cream 4 0.23 0.19–0.27
* Cooked sausages of the “doctor’s sausage” type. ** For example hamburger, kebab, McDonald’s Big
Mac, cheeseburger.
1 According to data from the NBS, consumption of bread and bakery products per capita in 2016 constituted 116.8 kg,
which is equal to 320 g per day (31).
More than half (57.2%) of the 856 households visited consumed salt containing
15 mg/kg of iodine or more, while 23% of them consumed salt that was not iodized
(Table 4.29).2 The consumption of iodized salt was significantly higher in urban
compared to rural areas (77.9% versus 44.5%, respectively (p<0.001)); it was associated
with a higher level of education (from 50.3% in those with lower-secondary school
qualifications to 72.9% in those with university-level education or higher (p<0.001))
and increasing wealth (from 50.6% in quintile 1 of the wealth index to 80.9% in
quintile 5 (p=0.001)) (Table 4.29).
Table 4.29. Consumption of iodized salt per household by area of residence, level of
education and wealth index
No. of Percentage of households with salt test results P-value
households Not iodized >0 and <15 mg/ ≥ 15 mg/kg
0 mg/kg kg
Total 856 196 (22.9) 170 (19.9) 490 (57.2)
Area
Urban 326 32 (9.8) 40 (12.3) 254 (77.9) <0.001
Rural 530 164 (30.9) 130 (24.5) 236 (44.5)
Level of education
Total 808 182 (22.5) 157 (19.4) 469 (58.0)
Lower-secondary <0.001
school/ 185 53 (28.6) 39 (21.1) 93 (50.3)
gymnasium
Upper-secondary
180 47 (26.1) 34 (18.9) 99 (55.0)
school/lyceum
College/
260 60 (23.1) 55 (21.2) 145 (55.8)
vocational school
University/
postgraduate 181 22 (12.2) 27 (14.9) 132 (72.9)
degree
Wealth index (per year)
Total 430 73 (17.0) 65 (15.1) 292 (67.9)
Quintile 1 77 19 (24.7) 19 (24.7) 39 (50.6) 0.001
Quintile 2 70 19 (27.1) 7 (10.0) 44 (62.9)
Quintile 3 95 11 (11.6) 14 (14.7) 70 (73.7)
Quintile 4 94 16 (17.0) 15 (16.0) 63 (67.0)
Quintile 5 94 8 (8.5) 10 (10.6) 76 (80.9)
2 Of the 858 households (matching individuals) included in the analysis, two did not have iodine measurements, so the final
sample for the iodine analysis was 856.
5. CONCLUSIONS
D
iseases of the circulatory system are the leading cause of morbidity, disability
and mortality in the Republic of Moldova, accounting for every second death
in recent years. Unhealthy diet and high blood pressure are two main risk
factors for CVD that account for most of the disease burden in the country. High salt
consumption is a significant determinant of high blood pressure.
Almost half of the adult population has raised blood pressure, with no difference
between the sexes. About two thirds of the population were not taking medication and
had raised blood pressure, with this being the case more among men than women.
A modest reduction in blood pressure would have important public health benefits.
Reducing salt intake at the population level would reduce the risk of heightened
blood pressure and CVD.
Salt intake in adults in the Republic of Moldova (especially in men) exceeds by more
than twofold the WHO recommended maximum population target of 5 g/day. Bread
is the biggest contributor of salt to the diet, providing more than the recommended
daily salt intake for the majority of the population. Adding salt to food always or
often when cooking, before eating or while eating, is a common practice among the
population of the Republic of Moldova. A comprehensive programme for reducing
salt intake among the population needs to be implemented at national level through
systematic efforts, including raising public awareness and changing behaviours
through communication (for example via health care professionals and education
in schools). Structured programmes should also be implemented to: reformulate
industrially processed food; set the framework for the food industry to reduce salt;
introduce labelling to highlight the salt content of foods; and monitor and evaluate
salt intake.
Based on international experience and using national dietary intake data, the
Government of the Republic of Moldova can set salt reduction targets by food category
Only one in two people consume sufficient potassium in the country. In response to
this, public policies should be directed towards encouraging an increase in intake
of fruit, vegetables, pulses and nuts to increase potassium consumption to at least
90 mmol/day. Increasing availability and affordability, along with health promotion
and health education activities, can contribute to achieving this.
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Mapping-salt-reduction-initiatives-in-the-WHO-European-Region.pdf).
13. Cappuccio FP, Capewell S, Lincoln P, McPherson K. Policy options to reduce population salt
28. Cappuccio FP, Ji C, Donfrancesco C, Palmieri L, Ippolito R, Vanuzzo D, et al. Geographic and
socioeconomic variation of sodium and potassium intake in Italy: results from the MINISAL-
GIRCSI programme. BMJ Open 2015: 5(9):e007467 (http://bmjopen.bmj.com/content/5/9/
e007467).
29. Guideline: potassium intake for adults and children. Geneva: World Health Organization; 2012
(reprinted 2014) (http://apps.who.int/iris/bitstream/handle/10665/77986/9789241504829_eng.
pdf?sequence=1).
30. Salt reduction and iodine fortification strategies in public health: report of a joint technical
meeting convened by the World Health Organization and The George Institute for Global Health
in collaboration with the International Council for the Control of Iodine Deficiency Disorders
Global Network, Sydney, Australia, March 2013. Geneva: World Health Organization; 2014 (http://
apps.who.int/iris/bitstream/handle/10665/101509/9789241506694_eng.pdf?sequence=1).
31. Statistics Moldova. Consumul principalelor produse alimentare pe medii, 2006-2017 [Main
food consumption by areas, 2006–2017]. Chișinău: National Bureau of Statistics of the Republic
of Moldova; 2017 (http://statbank.statistica.md/pxweb/pxweb/en/30%20Statistica%20
sociala/30%20Statistica%20sociala__04%20NIV__NIV060/NIV060100.px/?rxid=8ebd14c1-7adf-
494b-9840-9cb85498f247).
Demographic information
Question Response Code
In total, how many years have you
spent at school and in full-time Years C1
study (excluding preschool)? └─┴─┘
No formal schooling/less than primary school 1
Primary school completed (gr.1–4) 2
Gymnasium completed (gr.5–9) 3
What is the highest level of
education you have completed?
Lyceum/secondary school completed 4 C2
College/vocational school completed 5
University completed/ postgraduate degree 6
Refused 88
Romanian/Moldovan 1
Russian 2
Ukrainian 3
What is your ethnic group/
background?
Roma 4 C3
Gagauz 5
Other ethnic groups 6
Refused 88
Never married 1
Currently married 2
Separated 3
What is your marital status? Divorced 4 C4
Widowed 5
Cohabitating 6
Refused 88
Government employee 1
Non-government or private employee 2
Which of the following best
Self-employed 3
describes your main work status
over the past 12 months? Non-paid 4
Student 5
C5
Homemaker 6
Retired 7
Unemployed (able to work) 8
Unemployed (unable to work) 9
Refused 88
How many people older than 18
years, including yourself, live in Number of people C6
your household? └─┴─┘
Taking into account the past 12
months, can you tell me what the └─┴─┴─┴─┴─┴─┴─┘ Go to D1
average monthly earnings (MDL) of Refused 88
C7a
the household have been?
_ 2000 1
<
If you don’t know the amount, can More than 2000, <
_ 3500 2
you give an estimate of the monthly
household income during the last 12 More than 3500, <
_ 5000 3
month if I read some options to you? C8
Is it: More than 5000, <
_ 7500 4
More than 7500 5
Don’t know 77
Refused 88
The next questions ask about the fruit and vegetable that you usually eat. I have a nutrition card here that
shows some examples of local fruits and vegetables. Each picture represents the size of a serving. As you
answer these questions please think of a typical week in the last year.
Question Response Code
In a typical week, on how many days do you
Number of days
eat fruit? Don’t know 77 D1
(USE SHOW CARD)
└─┴─┘ If Zero days, go to D3
Vegetable oil 1
Lard or suet 2
Butter or ghee 3
D5
Other
└─┴─┴─┴─┴─┴─┴─┘
other
On average, how many meals per week do
you eat that were not prepared at a home? Number
Don’t know └─┴─┘ D6
By meal, I mean breakfast, lunch and dinner. 77
Now I will ask you some questions about your diet during the last year.
For every food, a quantity is mentioned, a medium portion or a usually a unit used in the household,
such as a slice or a spoon. The interviewer will mark (+) in the box to specify how often, on average, the
participant eats the specified quantity of the following food during the last year (USE SHOW CARD).
How often have you eaten Average consumption during last year
the following foods and in Never 1-3 Once 2-4 5-6 Once 2-3 4-5 6+ per Re- Don’t
what quantity? or less times per times times per times times day fused know
than per week per per day per per
once month week week day day 88 77
per
month
Bread (one slice)
White bread F1
Black bread F2
Whole cereals bread F3
Cereals/rice porridge (a portion F4
= 5 spoons = 80 g)
Breakfast cereals (muesli, F5
cornflakes, oats) (a portion = 5
spoons = 80 g)
Potatoes and pasta (medium portion = 80 g)
Chips F6
Pizza (slice) F7
Pies F8
Pasta, macaroni (medium F9
portion)
Salty snacks (salty nuts, F10
biscuits, crackers)
Processed meat products (medium portion = 80 g)
Sausages, salami (boiled), F11
liver sausage
Pastrami, smoked ham, cured/ F12
smoked salami
Canned meat F13
Semi-prepared meat products F14
(mici, pârjoale)
Fish products (medium portion = 80 g)
Salty/smoked/marinated fish F15
Canned fish F16
Dairy products (medium portion = 80 g)
Hard and soft cheese F17
Sheep’s cheese F18
Other foods
Pickled vegetables (medium F19
portion = 80 g), (USE SHOW
CARD)
Marinated vegetables (medium F20
portion) (USE SHOW CARD)
Sauces (ketchup, mayonnaise, F21
adjica, other sauces) (medium
portion = one spoon)
With the next questions, we would like to learn more about salt in your diet. Dietary salt includes ordinary table salt, unrefined
salt such as see salt, iodized salt, salty powder (extra), salty cubes, coarse and rock salt and salty sauces, such as ketchup,
adjika, and soya sauce (USE SHOW CARD). The following questions are on adding salt to the food right before you eat it, on
how food is prepared in your home, on eating processed foods that are high in salt, such as pickles, marinated foods, salty
herbs and seasonings, sheep’s and dairy salty cheese, sausages, pastrami, bacon, and other salty meat products, salty fish,
and questions on controlling your salt intake. Please answer the questions even if you consider yourself to eat a diet low in
salt.
During the past 3 years, has a doctor or other health worker advised you to do any of the following?
(Register for every one)
Yes 1
Stop smoking tobacco or don’t start K1
No 2
Yes 1
Reduce salt in your diet K2
No 2
4. Physical measurements
Question Response Code
Blood pressure
Device ID for blood pressure L1
Reading 1 Systolic (mmHg) _________ _________ _________ L2a
Diastolic (mmHg) _________ _________ _________ L3a
Reading 2 Systolic (mmHg) _________ _________ _________ L2b
Diastolic (mmHg) _________ _________ _________ L3b
Reading 3 Systolic (mmHg) _________ _________ _________ L2c
Diastolic (mmHg) _________ _________ _________ L3c
Heart Rate
Reading 1 Beats per minute _________ _________ _________ L5a
Reading 2 Beats per minute _________ _________ _________ L5b
Reading 3 Beats per minute _________ _________ _________ L5c
Height and Weight
Device ID for height and weight M1
Height in centimetres (cm) _______ ________ _______, ______ M2
Weight
in kilograms (kg) _______ ________ _______, ______ M3
If too heavy for scale 666.6
Waist
Device ID for waist O1
Waist circumference in centimetres (cm) _______ ________ _______, ______ O2
Hip circumference in centimetres (cm) _______ ________ _______, ______ O3
Part II
Participant ID └─┴─┴─┴─┴
Yes 1
Urine sample collection No 2 If NO, END
E3
7. Household salt
The survey participant is asked to present the salt usually used for cooking and as the table salt
Yes 1 P1
Household sample collection
No 2
Participant ID
└─┴─┴─┴─┘
Urinary sodium content In milligrams (mg) / 24 hrs _____________________ U1
Urinary potassium content In mg / 24 hrs _____________________ U2
Urinary creatinine content In mg / 24 hrs _____________________ U3
Urinary iodine content In micrograms / 24 hrs _____________________ U4
Salt iodine content In mg / kg _____________________ U5
Men
Without formal College/
Age Primary Lower- Secondary University/
schooling/not vocational
(years) school secondary/ school/ postgraduate
n completed school
completed gymnasium lyceum degree
primary school completed
(%) completed (%) completed (%) completed (%)
(%) (%)
18–29 43 – – 18.6 20.9 20.9 39.5
30–44 89 – – 15.7 18.0 38.2 28.1
45–59 109 – – 21.1 23.9 45.0 10.1
60–69 71 – – 23.9 19.7 38.0 18.3
18–69 312 – – 19.9 20.8 38.1 21.2
Women
Without formal Secondary College/
Age Primary Lower- University/
schooling/ school/ vocational
(years) school secondary/ postgraduate
n not completed lyceum school
completed gymnasium degree
primary school completed completed
(%) completed (%) completed (%)
(%) (%) (%)
18–29 62 1.6 0.0 25.8 24.2 11.3 37.1
30–44 126 0.0 0.0 22.2 19.0 25.4 33.3
45–59 169 0.0 0.6 19.5 28.4 34.3 17.2
60–69 140 0.0 0.0 32.9 20.0 31.4 15.7
18–69 497 0.2 0.2 24.7 23.1 28.4 23.3
Both sexes
Without formal Secondary College/
Age Primary Lower- University/
schooling/ school/ vocational
(years) school secondary/ postgraduate
n not completed lyceum school
completed gymnasium degree
primary school completed completed
(%) completed (%) completed (%)
(%) (%) (%)
18–29 105 1.0 0.0 22.9 22.9 15.2 38.1
30–44 215 0.0 0.0 19.5 18.6 30.7 31.2
45–59 278 0.0 0.4 20.1 26.6 38.5 14.4
60–69 211 0.0 0.0 29.9 19.9 33.6 16.6
18–69 809 0.1 0.1 22.9 22.2 32.1 22.5
Both sexes
Age (years) Ethnic
Ethnic Ethnic Ethnic Ethnic Other ethnic
n Romanian/
Russian (%) Ukrainian (%) (Roma) (%) (Gagauz) (%) group (%)
Moldovan (%)
18–29 105 89.5 2.9 0.0 0.0 6.7 1.0
30–44 215 85.6 6.0 5.1 0.5 2.3 0.5
45–59 278 82.7 2.9 6.5 0.0 7.6 0.4
60–69 211 82.5 6.2 5.2 0.5 5.2 0.5
18–69 809 84.3 4.6 4.9 0.2 5.4 0.5
Men
Age (years) Never Currently
n Separated (%) Divorced (%) Widowed (%) Cohabitating (%)
married (%) married (%)
18–29 43 62.8 34.9 0.0 2.3 0.0 0.0
30–44 89 9.0 78.7 0.0 11.2 1.1 0.0
45–59 109 2.8 79.8 3.7 10.1 2.8 0.9
60–69 70 1.4 62.9 11.4 4.3 18.6 1.4
18–69 311 12.5 69.5 3.9 8.0 5.5 0.6
Women
Age (years) Never Currently
n Separated (%) Divorced (%) Widowed (%) Cohabitating (%)
married (%) married (%)
18–29 62 38.7 46.8 6.5 4.8 1.6 1.6
30–44 124 9.7 70.2 7.3 8.1 1.6 3.2
45–59 169 1.2 66.9 5.3 5.9 18.9 1.8
60–69 140 2.1 33.6 5.0 7.9 50.7 0.7
18–69 495 8.3 55.8 5.9 6.9 21.4 1.8
Both sexes
Age (years) Never Currently
n Separated (%) Divorced (%) Widowed (%) Cohabitating (%)
married (%) married (%)
18–29 105 48.6 41.9 3.8 3.8 1.0 1.0
30–44 213 9.4 73.7 4.2 9.4 1.4 1.9
45–59 278 1.8 71.9 4.7 7.6 12.6 1.4
60–69 210 1.9 43.3 7.1 6.7 40.0 1.0
18–69 806 9.9 61.0 5.1 7.3 15.% 1.4
Men
Age (years) Government Non-government
n Self-employed (%) Unpaid (%)
employee (%) employee (%)
18–29 43 16.3 41.9 14.0 27.9
30–44 89 12.4 32.6 32.6 22.5
45–49 109 22.0 24.8 33.0 20.2
60–69 71 9.9 7.0 8.5 74.6
18–69 312 15.7 25.3 24.7 34.3
Women
Age (years) Government Non-government
n Self-employed (%) Unpaid (%)
employee (%) employee (%)
18–29 62 22.6 16.1 8.1 53.2
30–44 126 29.4 23.8 9.5 37.3
45–49 169 29.0 13.6 12.4 45.0
60–69 140 8.6 2.1 1.4 87.9
18–69 497 22.5 13.3 8.0 56.1
Both sexes
Age
(years) Government Non-government
n Self-employed (%) Unpaid (%)
employee (%) employee (%)
18–29 105 20.0 26.7 10.5 42.9
30–44 215 22.3 27.4 19.1 31.2
45–49 278 26.3 18.0 20.5 35.3
60–69 211 9.0 3.8 3.8 83.4
18–69 809 19.9 17.9 14.5 47.7
Men
Unemployed
Age (years) Home-
n Unpaid (%) Student (%) Retired (%) Not able to
maker (%) Able to work (%)
work (%)
18–29 12 0.0 66.7 8.3 0.0 25.0 0.0
30–44 20 5.0 0.0 35.0 0.0 55.0 5.0
45–59 22 0.0 0.0 50.0 9.1 36.4 4.5
60–69 53 0.0 0.0 7.5 90.6 1.9 0.0
18–69 107 0.9 7.5 21.5 46.7 21.5 1.9
Women
Unemployed
Age (years) Home-
n Unpaid (%) Student (%) Retired (%) Not able to
maker (%) Able to work (%)
work (%)
18–29 33 3.0 30.3 36.4 0.0 30.3 0.0
30–44 47 2.1 0.0 80.9 2.1 12.8 0.0
45–59 76 0.0 0.0 51.3 39.5 5.3 2.6
60–69 123 0.0 0.0 0.8 99.2 0.0 0.0
18–69 279 0.7 3.6 32.3 54.8 7.2 0.7
Both sexes
Unemployed
Age (years) Home-
n Unpaid (%) Student (%) Retired (%) Not able to
maker (%) Able to work (%)
work (%)
18–29 45 2.2 40.0 28.9 0.0 28.9 0.0
30–44 67 3.0 0.0 67.2 1.5 25.4 1.5
45–59 98 0.0 0.0 51.0 32.7 12.2 3.1
60–69 176 0.0 0.0 2.8 96.6 0.6 0.0
18–69 386 0.8 4.7 29.3 52.6 11.1 1.0
Table A18. Body mass index (BMI) by sex and area of residence
Men
Age Normal weight Overweight
Under-weight 18.5–24.9 kg/m2 Obese
(years) n 25.0–29.9
< 18.5 kg/m2 (%) ≥ 30.0 kg/m2 (%)
(%) kg/m2 (%)
18–29 44 6.8 61.4 29.5 2.3
30–44 92 0.0 35.9 45.7 18.5
45–59 115 0.9 26.1 36.5 36.5
60–69 72 0.0 23.6 41.7 34.7
18–69 323 1.2 33.1 39.3 26.3
Women
Age Normal weight Overweight
(years) Under-weight Obese
n 18.5–24.9 kg/m2 25.0–29.9
< 18.5 kg/m2 (%) ≥ 30.0 kg/m2 (%)
(%) kg/m2 (%)
18–29 63 4.8 65.1 19.0 11.1
30–44 130 3.8 34.6% 36.2 25.4
45–59 180 0.0 16.7 38.9 44.4
60–69 151 0.7 11.3 45.0 43.0
18–69 524 1.7 25.4 37.6 35.3
Both sexes
Age
(years) Under-weight Normal weight Overweight 25.0– Obese ≥ 30.0 kg/
n
< 18.5 kg/m2 (%) 18.5–24.9 kg/m2 (%) 29.9 kg/m2 (%) m2 (%)
18–29 107 5.6 63.6 23.4 7.5
30–44 222 2.3 35.1 40.1 22.5
45–59 295 0.3 20.3 38.0 41.4
60–69 223 0.4 15.2 43.9 40.4
18–69 847 1.5 28.3 38.3 31.9
Table A24. Prevalence of hypertension (SBP ≥ 140 and/or DBP ≥ 90 mmHg), excluding
those taking medication for raised blood pressure, by sex and age group
Table A27. Prevalence of hypertension (SBP ≥ 160 and/or DBP ≥ 100 mmHg, or currently
taking medication for raised blood pressure), by sex and age group
Table A28. Male respondents with treated and/or controlled raised blood pressure,
by age group
Men
Age Taking medication and Taking medication and Not taking medication
(years) n SBP < 140 and DBP < SBP ≥ 140 and DBP ≥ and SBP ≥ 140 and DBP
90 (%) 90 (%) ≥ 90 (%)
18–29 9 0.0 0.0 100.0
30–44 24 4.2 4.2 91.7
45–59 69 2.9 15.9 81.2
60–69 46 0.0 23.9 76.1
18–69 148 2.0 15.5 82.4
Table A29. Male respondents with treated and/or controlled raised blood pressure,
by area of residence
Men
Area Taking medication and Taking medication and Not taking medication
n SBP < 140 and DBP < SBP ≥ 140 and DBP ≥ and SBP ≥ 140 and DBP
90 (%) 90 (%) ≥ 90 (%)
Rural 94 2.1 14.9 83.0
Urban 54 1.9 16.7 81.5
Total 148 2.0 15.5 82.4
Women
Age Taking medication and Taking medication and Not taking medication
(years) n SBP < 140 and DBP < SBP ≥ 140 and DBP ≥ and SBP ≥ 140 and DBP
90 (%) 90 (%) ≥ 90 (%)
18–29 9 0.0 0.0 100.0
30–44 32 0.0 9.4 90.6
45–59 90 6.7 20.0 73.3
60–69 106 7.5 35.8 56.6
18–69 237 5.9 24.9 69.2
Table A31. Female respondents with treated and/or controlled raised blood pressure,
by area of residence
Women
Area Taking medication and Taking medication and Not taking medication
n SBP < 140 and DBP < SBP ≥ 140 and DBP ≥ and SBP ≥ 140 and DBP
90 (%) 90 (%) ≥ 90 (%)
Rural 158 7.0 24.1 69.0
Urban 79 3.8 26.6 69.6
Total 237 5.9 24.9 69.2
Table A32. Respondents (both sexes) with treated and/or controlled raised blood
pressure, by age group
Both sexes
Age Taking medication and Taking medication and Not taking medication
(years) n SBP < 140 and DBP < SBP ≥ 140 and DBP ≥ and SBP ≥ 140 and DBP
90 (%) 90 (%) ≥ 90 (%)
18–29 18 0.0 0.0 100.0
30–44 56 1.8 7.1 91.1
45–59 159 5.0 18.2 76.7
60–69 152 5.3 32.2 62.5
18–69 385 4.4 21.3 74.3
Table A33. Respondents (both sexes) with treated and/or controlled raised blood
pressure, by area of residence
Both sexes
Area Taking medication and Taking medication and Not taking medication
n SBP < 140 and DBP < SBP ≥ 140 and DBP ≥ and SBP ≥ 140 and DBP
90 (%) 90 (%) ≥ 90 (%)
Rural 252 5.2 20.6 74.2
Urban 133 3.0 22.6 74.4
Total 385 4.4 21.3 74.3
Age
n Mean Median SD 95% CI
(years)
Men
18–29 44 222.4 199.3 136.7 180.8–263.9
30–44 92 242.8 206.6 154.8 210.8–274.9
45–59 117 211.2 182.8 163.7 181.2–241.1
60–69 73 256.9 216.3 146.9 222.6–291.1
Women
18–29 64 219.2 203.6 144.3 183.1–255.2
30–44 133 200.2 179.7 127.0 178.4–222.0
45–59 179* 236.2 190.7 169.6 211.2–261.3
60–69 154 220.9 194.5 145.8 197.7–244.1
*Men: p=0.2; Women: p=0.2, by ANOVA.
8.3 DIET
Table A37. Mean number of days consuming fruit in a typical week, by age group
and sex
Table A39. Mean number of days consuming vegetables in a typical week, by age
group and sex
Table A40. Mean number of days consuming vegetables in a typical week, by area of
residence and sex
Table A41. Mean number of servings of fruit on average per day, by age group and sex
Table A43. Mean number of servings of vegetables on average per day, by age group
and sex
Table A44. Mean number of servings of vegetables on average per day, by area of
residence and sex
Table A45. Mean number of servings of fruit and/or vegetables on average per day,
by age group and sex
Table A47. Number of servings of fruit and/or vegetables on average per day among
men, by age group
Table A48. Number of servings of fruit and/or vegetables on average per day among
women, by age group
Table A49. Number of servings of fruit and/or vegetables on average per day among
both sexes, by age group
Table A53. Average consumption of bread among both sexes, by age group
FC1 White bread
Age Once per week 2–4 days per 5–6 days per 2–3 times per 4–6 times per
Once per day
(years) or less week week day day
n % n % n % n % n % n %
18–29 22 20.6 7 6.5 4 3.7 16 15.0 57 53.3 1 0.9
30–44 42 18.9 10 4.5 2 0.9 41 18.5 112 50.5 15 6.8
45–59 54 18.3 16 5.4 7 2.4 42 14.2 170 57.6 6 2.0
60–69 56 25.0 13 5.8 1 0.4 18 8.0 131 58.5 5 2.2
18–69 174 20.5 46 5.4 14 1.7 117 13.8 470 55.4 27 3.2
FC2 Black bread
Once per week 2–4 days per 5–6 days per 4–6 times
Age (years) Once per day 2–3 times per day
or less week week per day
n % n % n % n % n % n %
18–29 58 54.2 10 9.3 4 3.7 23 21.5 12 11.2 0 0.0
30–44 114 51.8 15 6.8 4 1.8 48 21.8 39 17.7 0 0.0
45–59 143 48.6 26 8.8 4 1.4 56 19.0 64 21.8 1 0.3
60–69 117 52.2 16 7.1 4 1.8 28 12.5 57 25.4 2 0.9
18–69 432 51.1 67 7.9 16 1.9 155 18.3 172 20.4 3 0.4
FC3 Whole-grain bread
Once per week 2–4 days per 5–6 days per 2–3 times per 4–6 times per
Age (years) Once per day
or less week week day day
n % n % n % n % n % n %
18–29 95 89.6 4 3.8 0 0.0 3 2.8 2 1.9 2 1.9
30–44 189 85.5 9 4.1 2 0.9 18 8.1 3 1.4 0 0.0
45–59 272 92.2 7 2.4 1 0.3 12 4.1 3 1.0 0 0.0
60–69 202 91.0 6 2.7 1 0.5 8 3.6 3 1.4 2 0.9
18–69 758 89.8 26 3.1 4 0.5 41 4.9 11 1.3 4 0.5
Table A57. Average consumption of cereals among both sexes, by age group
FC4 Cereals/rice porridge
Once per week 2–4 days per 5–6 days per 2–3 times per 4–6 times per
Age (years) Once per day
or less week week day day
n % n % n % n % n % n %
18–29 47 43.9 30 28.0 1 0.9 26 24.3 3 2.8 0 0.0
30–44 99 44.6 63 28.4 9 4.1 50 22.5 1 0.5 0 0.0
45–59 88 29.8 132 44.7 5 1.7 68 23.1 1 0.3 1 0.3
60–69 74 33.2 91 40.8 5 2.2 52 23.3 1 0.4 0 0.0
18–69 308 36.4 316 37.3 20 2.4 196 23.1 6 0.7 1 0.1
Table A58. Average consumption of cereals among both sexes, by area of residence
FC4 Cereals/rice porridge
Once per week or 2–4 days per 5–6 days per 2–3 times per 4–6 times
Area Once per day
less week week day per day
n % n % n % n % n % n %
Rural 188 35.9 216 41.3 13 2.5 100 19.1 5 1.0 1 0.2
Urban 120 37.0 100 30.9 7 2.2 96 29.6 1 0.3 0 0.0
Total 308 36.4 316 37.3 20 2.4 196 23.1 6 0.7 1 0.1
Table A60. Average consumption of pizza, pie and pasta among women, by age group
FC7 Pizza (slice)
Once per week or 2–4 days per 5–6 days per 2–3 times per 4–6 times per
Age (years) Once per day
less week week day day
n % n % n % n % n % n %
18–29 61 96.8 2 3.2 0 0.0 0 0.0 0 0.0 0 0.0
30–44 127 98.4 2 1.6 0 0.0 0 0.0 0 0.0 0 0.0
45–59 180 100.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
60–69 151 100.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
18–69 519 99.2 4 0.8 0 0.0 0 0.0 0 0.0 0 0.0
FC8 Pies
Once per week 2–4 days per 5–6 days per 2–3 times per 4–6 times per
Age (years) Once per day
or less week week day day
n % n % n % n % n % n %
18–29 42 66.7 19 30.2 1 1.6 1 1.6 0 0.0 0 0.0
30–44 107 82.3 21 16.2 1 0.8 1 0.8 0 0.0 0 0.0
45–59 146 81.1 30 16.7 1 0.6 2 1.1 1 0.6 0 0.0
60–69 135 90.0 13 8.7 0 0.0 2 1.3 0 0.0 0 0.0
18–69 430 82.2 83 15.9 3 0.6 6 1.1 1 0.2 0 0.0
FC9 Pasta (macaroni; medium portion)
Once per week 2–4 days per 5–6 days per 2–3 times per 4–6 times per
Age (years) Once per day
or less week week day day
n % n % n % n % n % n %
18–29 44 69.8 15 23.8 0 0.0 3 4.8 1 1.6 0 0.0
30–44 92 70.8 33 25.4 0 0.0 4 3.1 1 0.8 0 0.0
45–59 118 65.6 55 30.6 2 1.1 4 2.2 1 0.6 0 0.0
60–69 107 70.9 34 22.5 3 2.0 6 4.0 1 0.7 0 0.0
18–69 361 68.9 137 26.1 5 1.0 17 3.2 4 0.8 0 0.0
FC8 Pies
Once per week 2–4 days per 5–6 days per 2–3 times per 4–6 times per
Age (years) Once per day
or less week week day day
n % n % n % n % n % n %
18–29 63 58.9 40 37.4 2 1.9 2 1.9 0 0.0 0 0.0
30–44 165 74.3 53 23.9 1 0.5 3 1.4 0 0.0 0 0.0
45–59 235 79.7 52 17.6 3 1.0 3 1.0 1 0.3 1 0.3
60–69 193 86.5 25 11.2 1 0.4 4 1.8 0 0.0 0 0.0
18–69 656 77.4 170 20.1 7 0.8 12 1.4 1 0.1 1 0.1
Table A62. Average consumption of pizza, pie and pasta among both sexes,
by area of residence
FC8 Pies
Once per week or 2–4 days per 5–6 days per 2–3 times per 4–6 times per
Area Once per day
less week week day day
n % n % n % n % n % n %
Rural 438 83.6 73 13.9 3 0.6 8 1.5 1 0.2 1 0.2
Urban 218 67.5 97 30.0 4 1.2 4 1.2 0 0.0 0 0.0
Total 656 77.4 170 20.1 7 0.8 12 1.4 1 0.1 1 0.1
Table A64. Average consumption of chips and salty snacks among women, by age group
FC6 Chips
Once per week or 2–4 days per 5–6 days per 2–3 times per 4–6 times per
Age (years) Once per day
less week week day day
n % n % n % n % n % n %
18–29 62 98.4 1 1.6 0 0.0 0 0.0 0 0.0 0 0.0
30–44 130 100.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
45–59 179 99.4 0 0.0 0 0.0 1 0.6 0 0.0 0 0.0
60–69 151 100.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
18–69 522 99.6 1 0.2 0 0.0 1 0.2 0 0.0 0 0.0
FC6 Chips
Once per week or 2–4 days per 5–6 days per 2–3 times per 4–6 times per
Age (years) Once per day
less week week day day
n % n % n % n % n % n %
18–29 105 98.1 1 0.9 0 0.0 0 0.0 1 0.9 0 0.0
30–44 221 99.5 1 0.5 0 0.0 0 0.0 0 0.0 0 0.0
45–59 292 99.3 1 0.3 0 0.0 1 0.3 0 0.0 0 0.0
60–69 224 100.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
18–69 842 99.4 3 0.4 0 0.0 1 0.1 1 0.1 0 0.0
Table A66. Average consumption of chips and salty snacks among both sexes, by area
of residence
FC6 Chips
Once per week or 2–4 days per 5–6 days per 2–3 times per 4–6 times per
Area Once per day
less week week day day
n % n % n % n % n % n %
Rural 521 99.6 0 0.0 0 0.0 1 0.2 1 0.2 0 0.0
Urban 321 99.1 3 0.9 0 0.0 0 0.0 0 0.0 0 0.0
Total 842 99.4 3 0.4 0 0.0 1 0.1 1 0.1 0 0.0
Table A71. Average consumption of processed fish products among men, by age group
Table A73. Average consumption of processed fish products among both sexes,
by age group
Table A75. Average consumption of dairy products among men, by age group
Table A77. Average consumption of dairy products among both sexes, by age group
Table A79. Average consumption of other foodstuffs among men, by age group
Table A81. Average consumption of other foodstuffs among both sexes, by age group
Table A83. Add salt always or often before eating or while eating, by age group and sex
Table A84. Add salt always or often before eating or while eating, by area of
residence and sex
Table A86. Add salt always or often when cooking or preparing food at home, by
area of residence and sex
Table A87. Use iodized salt when cooking or preparing food at home, by age group
and sex
Table A88. Use iodized salt when cooking or preparing food at home, by area of
residence and sex
Table A89. Always or often consume processed food which is high in salt, by age
group and sex
Table A91. Think they consume far too much or too much salt, by age group and sex
Table A92. Self-reported quantity of salt consumed among men, by age group
Men
Age group
Far too much Just the right
(years) n Too much (%) Too little (%) Far too little (%)
(%) amount (%)
18–29 44 2.3 15.9 79.5 0.0 0.0
30–44 92 3.3 31.5 60.9 1.1 1.1
45–59 115 5.2 27.8 60.9 0.9 0.0
60–69 73 8.2 27.4 57.5 5.5 0.0
18–69 324 4.9 27.2 62.7 1.9 0.3
Table A93. Self-reported quantity of salt consumed among women, by age group
Women
Age
(years) Far too much Just the right
n Too much (%) Too little (%) Far too little (%)
(%) amount (%)
18–29 63 4.8 15.9 76.2 0.0 1.6
30–44 130 8.5 20.0 61.5 3.8 1.5
45–59 180 5.6 21.1 65.6 3.3 0.6
60–69 151 2.6 13.2 74.2 6.6 0.7
18–69 524 5.3 17.9 68.3 4.0 1.0
Table A94. Self-reported quantity of salt consumed among both sexes, by age group
Both sexes
Age group
(years) Far too much Just the right
n Too much (%) Too little (%) Far too little (%)
(%) amount (%)
18–29 107 3.7 15.9 77.6 0.0 0.9
30–44 222 6.3 24.8 61.3 2.7 1.4
45–59 295 5.4 23.7 63.7 2.4 0.3
60–69 224 4.5 17.9 68.8 6.2 0.4
18–69 848 5.2 21.5 66.2 3.2 0.7
Table A96. The type of serious health problem male respondents think a high-salt
diet could cause, by age group
Men
Age
(years) High blood Osteoporosis Stomach Kidney stones None of the All of the
n
pressure (%) (%) cancer (%) (%) above (%) above (%)
18–29 36 55.6 30.6 16.7 44.4 0.0 25.0
30–44 64 54.7 23.4 6.2 37.5 0.0 35.9
45–59 65 64.6 16.9 3.1 43.1 1.5 23.1
60–69 44 52.3 15.9 6.8 27.3 0.0 29.5
18–69 209 57.4 21.1 7.2 38.3 0.5 28.7
Table A97. The type of serious health problem female respondents think a high-salt
diet could cause, by age group
Women
Age
(years) High blood Osteoporosis Stomach Kidney stones None of the All of the
n
pressure (%) (%) cancer (%) (%) above (%) above (%)
18–29 36 36.1 19.4 5.6 38.9 2.8 44.4
30–44 96 52.1 25.0 3.1 41.7 1.0 33.3
45–59 123 49.6 20.3 6.5 31.7 0.0 40.7
60–69 106 65.1 29.2 9.4 43.4 0.0 27.4
18–69 361 53.5 24.1 6.4 38.5 0.6 35.2
Table A98. The type of serious health problem respondents of both sexes think a
high-salt diet could cause, by age group
Both sexes
Age
High blood Osteoporosis Stomach Kidney stones None of the All of the
(years) n
pressure (%) (%) cancer (%) (%) above (%) above (%)
18–29 72 45.8 25.0 11.1 41.7 1.4 34.7
30–44 160 53.1 24.4 4.4 40.0 0.6 34.4
45–59 188 54.8 19.1 5.3 35.6 0.5 34.6
60–69 150 61.3 25.3 8.7 38.7 0.0 28.0
18–69 570 54.9 23.0 6.7 38.4 0.5 32.8
Table A99. The importance attributed by men to lowering salt in diet, by age group
Age Men
(years) n Very important (%) Somewhat important (%) Not-at-all important (%)
18–29 44 25.0 47.7 15.9
30–44 92 25.0 42.4 16.3
45–59 115 22.6 51.3 13.9
60–69 73 15.1 50.7 19.2
18–69 324 21.9 48.1 16.0
Table A101. The importance attributed by both sexes to lowering salt in diet, by age group
Table A102. Respondents that limit consumption of processed food, by age group
and sex
Table A103. Respondents that look at the salt or sodium content on food labels, by age
group and sex
Table A104. Respondents that buy low salt/sodium alternatives, by age group and sex
Table A106. Use spices other than salt when cooking, by age group and sex
Table A107. Avoid eating food prepared outside of home, by age group and sex
Table A108. Take other measures specifically to control salt intake, by age group
and sex
Table A109. Blood pressure measurements and diagnosis in men, by age group
Men
Age (years) Diagnosed, but
Never measured Measured, but not Diagnosed within
n not within past 12
(%) diagnosed (%) past 12 months (%)
months (%)
18–29 44 9.1 88.6 2.3 0.0
30–44 92 4.3 87.0 3.3 5.4
45–59 115 3.5 76.5 5.2 14.8
60–69 73 4.1 63.0 11.0 21.9
18–69 324 4.6 78.1 5.6 11.7
Table A110. Blood pressure measurements and diagnosis in women, by age group
Women
Age (years) Diagnosed, but
Never measured Measured, but not Diagnosed within
n not within past 12
(%) diagnosed (%) past 12 months (%)
months (%)
18–29 63 12.7 82.5 3.2 1.6
30–44 130 10.0 83.1 3.8 3.1
45–59 180 3.3 72.8 11.1 12.8
60–69 151 4.6 55.0 9.9 30.5
18–69 524 6.5 71.4 8.0 14.1
Table A111. Blood pressure measurements and diagnosis in both sexes, by age group
Both sexes
Age (years) Diagnosed, but
Never measured Measured, but not Diagnosed within
n not within past 12
(%) diagnosed (%) past 12 months (%)
months (%)
18–29 107 11.2 85.0 2.8 0.9
30–44 222 7.7 84.7 3.6 4.1
45–59 295 3.4 74.2 8.8 13.6
60–69 224 4.5 57.6 10.3 27.7
18–69 848 5.8 73.9 7.1 13.2
Table A112. Currently taking medication for raised blood pressure prescribed by a
doctor or health worker among those diagnosed, by age group and sex
Table 114. Currently receiving advice or treatment to lose weight for raised blood
pressure prescribed by a doctor or health worker among those diagnosed,
by age group and sex
Table 115. Currently receiving advice or treatment to stop smoking for raised blood
pressure prescribed by a doctor or health worker among those diagnosed, by age
group and sex
Table 116. Currently receiving advice to start or do more physical activity for raised
blood pressure prescribed by a doctor or health worker among those diagnosed, by
age group and sex
Table 118. Currently taking herbal or traditional remedy for raised blood pressure, by
age group and sex
Table A119. Blood sugar measurement and diagnosis in men, by age group
Men
Age (years) Diagnosed but
Never measured Measured but not Diagnosed within
n not within past 12
(%) diagnosed (%) past 12 months (%)
months (%)
18–29 44 20.5 79.5 0.0 0.0
30–44 92 13.0 85.9 1.1 0.0
45–59 115 12.2 86.1 0.0 1.7
60–69 73 15.1 76.7 2.7 5.5
18–69 324 14.2 83.0 0.9 1.9
Table A120. Blood sugar measurement and diagnosis in women, by age group
Women
Age (years) Diagnosed but
Never measured Measured but not Diagnosed within
n not within past 12
(%) diagnosed (%) past 12 months (%)
months (%)
18–29 63 30.2 68.3 0.0 1.6
30–44 130 20.8 78.5 0.0 0.8
45–59 180 13.9 79.4 2.2 4.4
60–69 151 15.2 80.1 2.0 2.6
18–69 524 17.9 78.1 1.3 2.7
Both sexes
Age (years) Diagnosed but Diagnosed within
Never measured Measured but not
n not within past 12 past 12 months
(%) diagnosed (%)
months (%) (%)
18–29 107 26.2 72.9 0.0 0.9
30–44 222 17.6 81.5 0.5 0.5
45–59 295 13.2 82.0 1.4 3.4
60–69 224 15.2 79.0 2.2 3.6
18–69 848 16.5 80.0 1.2 2.4
Table A122. Currently taking insulin prescribed for diabetes among those previously
diagnosed, by age group and sex
Table A123. Currently taking medication prescribed for diabetes among those
previously diagnosed, by age group and sex
Table A124. Currently receiving a special diet prescribed for diabetes among those
previously diagnosed, by age group and sex
Table A126. Currently receiving advice or treatment to stop smoking for diabetes
prescribed by a doctor or health worker among those diagnosed, by age group and
sex
Table A127. Currently receiving advice to start or do more physical activity for
diabetes prescribed by a doctor or health worker among those diagnosed, by age
group and sex
Table A128. Seen a traditional healer for diabetes, by age group and sex
Table A130. Having ever had a heart attack, or chest pain from heart disease, or a
stroke, by age group and sex
Table A131. Currently taking aspirin regularly to prevent or treat heart disease, by
age group and sex
Table A132. Currently taking statins regularly to prevent or treat heart disease, by
age group and sex
Table A133. Advised by a doctor or health worker to stop smoking / using tobacco
products or not to start, by age group and sex
Table A134. Advised by a doctor or health worker to reduce salt in diet, by age group
and sex
Table A135. Advised by a doctor or health worker to eat at least 5 servings of fruit
and/or vegetable each day, by age group and sex
Table A136. Advised by a doctor or health worker to reduce fat in diet, by age group
and sex
Table A138. Advised by a doctor or health worker to maintain a healthy body weight
or to lose weight, by age group and sex
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